Provider Demographics
NPI:1457034217
Name:ESTUPINAN, MONICA VANESSA (PMHNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:VANESSA
Last Name:ESTUPINAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 BISCAYNE BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3255
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:862-298-0794
Practice Address - Street 1:7171 SW 62ND AVE STE 300
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4723
Practice Address - Country:US
Practice Address - Phone:305-270-5305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027985363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health